Association between individuals with unilateral and bilateral carotid artery calcifications and periodontal disease: a cross-sectional study

Abstract Background This study investigated the association between unilateral and bilateral carotid artery calcifications (CAC) and periodontal disease severity using panoramic radiographs, and assessed the influence of systemic risk factors such as hypertension, diabetes, and smoking. Methods A re...

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Main Authors: Irem Melike Inan, Berrin Unsal, Sila Cagri Isler, Mujgan Firincioglulari, Dursun Valiyeva, Nurdan Ozmeric
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06272-z
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author Irem Melike Inan
Berrin Unsal
Sila Cagri Isler
Mujgan Firincioglulari
Dursun Valiyeva
Nurdan Ozmeric
author_facet Irem Melike Inan
Berrin Unsal
Sila Cagri Isler
Mujgan Firincioglulari
Dursun Valiyeva
Nurdan Ozmeric
author_sort Irem Melike Inan
collection DOAJ
description Abstract Background This study investigated the association between unilateral and bilateral carotid artery calcifications (CAC) and periodontal disease severity using panoramic radiographs, and assessed the influence of systemic risk factors such as hypertension, diabetes, and smoking. Methods A retrospective cross-sectional study analyzed 116 radiographs from 87 females and 29 males with CAC. CAC was identified as radiopaque lesions near the C3–C4 intervertebral space. Participants were categorized into unilateral or bilateral CAC groups. Demographic data, medical histories, and periodontal parameters (plaque index, gingival index (GI), bleeding on probing, probing depth (PD), and clinical attachment loss) were recorded. Participants were classified as healthy, gingivitis, periodontitis stage I–II, or stage III–IV. Binomial logistic regression and independent samples t-tests were used. Results Age and gender were not significantly associated with the type of CAC (p > 0.05). Only PD showed a significant association: an increase in PD was linked to higher odds of unilateral CAC and lower odds of bilateral CAC (p < 0.05). Smoking, diabetes, and hypertension were not significantly associated with the type of CAC (p > 0.05). Unilateral CAC was linked to higher GI, PD, and stage III–IV periodontitis, while bilateral CAC was more common in stage I–II (p < 0.05). Conclusion The findings suggest a differential association between the severity of periodontitis and the type of CAC. Unilateral CAC may be more strongly linked to advanced periodontal inflammation, possibly reflecting an earlier, inflammation-dominant phase of atherosclerosis. Due to the cross-sectional design and use of panoramic radiographs, causal inferences cannot be drawn. Further longitudinal studies using advanced imaging techniques are needed.
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spelling doaj-art-e97e8004aeef42dca3e5bbb6d89488122025-08-20T03:04:17ZengBMCBMC Oral Health1472-68312025-07-012511910.1186/s12903-025-06272-zAssociation between individuals with unilateral and bilateral carotid artery calcifications and periodontal disease: a cross-sectional studyIrem Melike Inan0Berrin Unsal1Sila Cagri Isler2Mujgan Firincioglulari3Dursun Valiyeva4Nurdan Ozmeric5Department of Periodontology, Gazi UniversityDepartment of Periodontology, Gazi UniversityDepartment of Periodontology, Gazi UniversityDepartment of Oral and Maxillofacial Radiology, Cyprus International UniversityDepartment of Periodontology, Gazi UniversityDepartment of Periodontology, Gazi UniversityAbstract Background This study investigated the association between unilateral and bilateral carotid artery calcifications (CAC) and periodontal disease severity using panoramic radiographs, and assessed the influence of systemic risk factors such as hypertension, diabetes, and smoking. Methods A retrospective cross-sectional study analyzed 116 radiographs from 87 females and 29 males with CAC. CAC was identified as radiopaque lesions near the C3–C4 intervertebral space. Participants were categorized into unilateral or bilateral CAC groups. Demographic data, medical histories, and periodontal parameters (plaque index, gingival index (GI), bleeding on probing, probing depth (PD), and clinical attachment loss) were recorded. Participants were classified as healthy, gingivitis, periodontitis stage I–II, or stage III–IV. Binomial logistic regression and independent samples t-tests were used. Results Age and gender were not significantly associated with the type of CAC (p > 0.05). Only PD showed a significant association: an increase in PD was linked to higher odds of unilateral CAC and lower odds of bilateral CAC (p < 0.05). Smoking, diabetes, and hypertension were not significantly associated with the type of CAC (p > 0.05). Unilateral CAC was linked to higher GI, PD, and stage III–IV periodontitis, while bilateral CAC was more common in stage I–II (p < 0.05). Conclusion The findings suggest a differential association between the severity of periodontitis and the type of CAC. Unilateral CAC may be more strongly linked to advanced periodontal inflammation, possibly reflecting an earlier, inflammation-dominant phase of atherosclerosis. Due to the cross-sectional design and use of panoramic radiographs, causal inferences cannot be drawn. Further longitudinal studies using advanced imaging techniques are needed.https://doi.org/10.1186/s12903-025-06272-zCarotid artery stenosisPanoramic radiographyPeriodontitisPeriodontal disease
spellingShingle Irem Melike Inan
Berrin Unsal
Sila Cagri Isler
Mujgan Firincioglulari
Dursun Valiyeva
Nurdan Ozmeric
Association between individuals with unilateral and bilateral carotid artery calcifications and periodontal disease: a cross-sectional study
BMC Oral Health
Carotid artery stenosis
Panoramic radiography
Periodontitis
Periodontal disease
title Association between individuals with unilateral and bilateral carotid artery calcifications and periodontal disease: a cross-sectional study
title_full Association between individuals with unilateral and bilateral carotid artery calcifications and periodontal disease: a cross-sectional study
title_fullStr Association between individuals with unilateral and bilateral carotid artery calcifications and periodontal disease: a cross-sectional study
title_full_unstemmed Association between individuals with unilateral and bilateral carotid artery calcifications and periodontal disease: a cross-sectional study
title_short Association between individuals with unilateral and bilateral carotid artery calcifications and periodontal disease: a cross-sectional study
title_sort association between individuals with unilateral and bilateral carotid artery calcifications and periodontal disease a cross sectional study
topic Carotid artery stenosis
Panoramic radiography
Periodontitis
Periodontal disease
url https://doi.org/10.1186/s12903-025-06272-z
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